III. Outcomes
As of July 2011, over 46,500 patients were placed on ECLS based on the
ELSO registry (see Table 2), with over 34,250 (74%) surviving ECLS, and over
28,700 (62%) surviving to discharge. Neonatal respiratory failure, which includes
persistent pulmonary hypertension (PPHN), meconium aspiration syndrome
(MAS), and congenital diaphragmatic hernia (CDH), has 85% survival from ECLS
and 75% survival to discharge (see Table 3). MAS has the best survival with
ECLS use at 94% with CDH having one of the worst at 51%. ECLS use for
cardiac failure in neonates has a survival off ECLS at 63% and survival to
discharge at 39%. Overall, VV is the most commonly used mode of ECLS for
respiratory failure. Though VA remains the most common support mode in
neonates, the use of VV steadily increasing in this population.[ 4 ]
In the pediatric population, respiratory failure has a 65% survival from
ECLS and 56% survived to discharge. Pneumonia secondary to various
infectious etiologies is the most common diagnosis with a 61% survival. The use
of VA is still more common in pediatric cases through cases started on VV are
45%. The use of DLVV is also increasing and is currently the predominant
mode of VV access.[ 4 ]
Adult cases of ECLS have traditionally been small, though is the most
rapidly growing segment coinciding with the use of ECLS for H1N1 infection, and
publication of the CESAR trial. ARDS is the most common indication for ECLS in
adults with survival rates around 51%. The highest survival of adults on ECLS is
with viral pneumonia at 65%. VV is the predominant mode of support (88%) with